成年女性舌骨位置与牙颌面相关指标的三维分析
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摘要
目的探讨成年女性牙颌面复合体的相关指标与舌骨位置的关联性,依据牙颌面相关因素回归分析得到较为敏感的指标。方法选取成年女性患者53例,18.4~30.7岁,平均22.7岁。拍摄自然头位下头颅侧位片和锥形束CT(CBCT)。应用Dolphin软件定点测量分析牙颌面以及舌骨位置的相关指标,采用SPSS 22.0软件进行分析。结果上颌第一磨牙中央窝之间的水平距离(U6CW)及上颌第一磨牙根分叉点之间的水平距离(U6FW)与舌骨点到下颌平面的水平距离(H-MP)呈负相关关系(r=-0.262,P=0.029;r=-0.313,P=0.023);下颌下角(FMA)与舌骨点到下颌平面的水平距离(H-MP)呈正相关关系(r=0.298,P=0.030);矢状向上,骨性Ⅱ类的舌骨位置低于骨性Ⅲ类(P=0.017);垂直向上、垂直生长型患者的舌骨位置比水平生长型以及平均生长型更低(P=0.016;P=0.014);舌体长度(TT-Eb)越长,则舌体位置越低,舌骨位置也越低(P=0.007)。结论成年女性舌骨位置与牙颌面复合体具有相关性,垂直生长型、牙弓狭窄及舌位置靠下的患者舌骨位置更靠下。
Objective To explore the correlation between the hyoid bone position and dental maxillofacial complex in adult women and to obtain the accurate measurement to predict the hyoid bone position. Methods A total of 53 female subjects aged 18.4-30.7 years(average 22.7 years) were selected. Lateral cephalograms and cone-beam computed tomography(CBCT) scans were performed. After orientation of the head posture,24 measurements of the dental maxillofacial complex,tongue and hyoid position were calculated with Dolphin Imaging software. And then these measurements were compared and analyzed using SPSS 22. 0 software. Results The upper first molars' central fossa width(U6 CW) was negatively correlated with the upper first molars' furcation width(U6 FW)(r =-0.262,P = 0.029),and the distance from hyoid to the mandibular plane(H-M P)(r =-0.313,P = 0.023). The lower mandibular angle(FM A)was positively correlated with H-M P(r = 0.298,P = 0.030). Hyoid bone position of Osseous Ⅱ was lower than that ofosseous Ⅲ(P = 0.017). The position of hyoid bone in patients with vertical growth patterns was lower than that in patients with horizontal and average growth patterns(P = 0.016; P = 0.014). The length of the tongue(TT-Eb) was positively correlated with the lowposition of the tongue and hyoid bone(P = 0.007). Conclusion The position of hyoid bone is correlated with the maxillofacial complex in adult women. In patients with vertical growth patterns,narrowdental arch and lowhyoid position,the hyoid bone position tend to be lower.
Objective To explore the correlation between the hyoid bone position and dental maxillofacial complex in adult women and to obtain the accurate measurement to predict the hyoid bone position. Methods A total of 53 female subjects aged 18.4-30.7 years(average 22.7 years) were selected. Lateral cephalograms and cone-beam computed tomography(CBCT) scans were performed. After orientation of the head posture,24 measurements of the dental maxillofacial complex,tongue and hyoid position were calculated with Dolphin Imaging software. And then these measurements were compared and analyzed using SPSS 22. 0 software. Results The upper first molars' central fossa width(U6 CW) was negatively correlated with the upper first molars' furcation width(U6 FW)(r =-0.262,P = 0.029),and the distance from hyoid to the mandibular plane(H-M P)(r =-0.313,P = 0.023). The lower mandibular angle(FM A)was positively correlated with H-M P(r = 0.298,P = 0.030). Hyoid bone position of Osseous Ⅱ was lower than that ofosseous Ⅲ(P = 0.017). The position of hyoid bone in patients with vertical growth patterns was lower than that in patients with horizontal and average growth patterns(P = 0.016; P = 0.014). The length of the tongue(TT-Eb) was positively correlated with the lowposition of the tongue and hyoid bone(P = 0.007). Conclusion The position of hyoid bone is correlated with the maxillofacial complex in adult women. In patients with vertical growth patterns,narrowdental arch and lowhyoid position,the hyoid bone position tend to be lower.
引文
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[17]Kim YH.A comparative cephalometric study of Class II,Division 1 nonextraction and extraction cases[J].Angle Orthod,1979,49(2):77-84.
[18]Alves MJ,Baratieri C,Mattos CT,et al.Is the airway volume being correctly analyzed?[J].Am J Orthod Dentofacial Orthop,2012,141(5):657-661.
[19]Chauhan A,Autar R,Pradhan KL,et al.Comparison of pharyngeal airw ay dimension,tongue and hyoid bone position based on ANB angle[J].Natl J M axillofac Surg,2015,6(1):42-51.
[20]Deljo E,Filipovic M,Babacic R,et al.Correlation analysis of the hyoid bone position in relation to the cranial base,mandible and cervical part of vertebra w ith particular reference to bimaxillary relations/teleroentgenogram analysis[J].Acta Inform M ed,2012,20(1):25-31.
[21]Malkoc S,Usumez S,Iseri H.Long-term effects of symphyseal distraction and rapid maxillary expansion on pharyngeal airw ay dimensions,tongue,and hyoid position[J].Am J Orthod Dentofacial Orthop,2007,132(6):769-775.
[22]Malkoc S,Usumez S,Nur M,et al.Reproducibility of airw ay dimensions and tongue and hyoid positions on lateral cephalograms[J].Am J Orthod Dentofacial Orthop,2005,128(4):513-516.
[23]Bickerton D,Szathmry E.Biological foundations and origin of syntax[M].Cambridge:M IT Press,2009:327-329
[24]Tarkar JS,Parashar S,Gupta G,et al.An evaluation of upper and low er pharyngeal airw ay w idth,tongue posture and hyoid bone position in subjects w ith different grow th patterns[J].J Clin Diagn Res,2016,10(1):79-83.
[25]Jena AK,Duggal R.Hyoid bone position in subjects w ith different vertical jaw dysplasias[J].Angle Orthod,2011,81(1):81-85.
[26]Paul D,Varma S,Ajith VV.Airway in Class I and Class II skeletal pattern:a computed tomography study[J].Contemp Clin Dent,2015,6(3):293-298.
[27]Gobeille DM,Bowman DC.Hyoid and muscle changes follow ing distal repositioning of the tongue[J].Am J Orthod,1976,70(3):282-289.
[28]Staudt CB,Gnoinski WM,Peltomaki T.Upper airway changes in Pierre Robin sequence from childhood to adulthood[J].Orthod Craniofac Res,2013,16(4):202-213.
[2]Verma G,Tandon P,Nagar A,et al.Cephalometric evaluation of hyoid bone position and pharyngeal spaces follow ing treatment w ith Tw in block appliance[J].J Orthod Sci,2012,1(3):77-82.
[3]Nishimura T.Developmental changes in the shape of the supralaryngeal vocal tract in chimpanzees[J].Am J Phys Anthropol,2005,126(2):193-204.
[4]Fitch WT,Giedd J.Morphology and development of the human vocal tract:a study using magnetic resonance imaging[J].J Acoust Soc Am,1999,106(1):1511-1522.
[5]Ebisumoto K,Okami K,Ogura G,et al.The predictive role of infiltrative grow th pattern in early pharyngeal cancers[J].Acta Otolaryngol,2015,135(11):1172-1177.
[6]Tsai HH.The positional changes of hyoid bone in children[J].J Clin Pediatr Dent,2002,27(1):29-34.
[7]Logemann JA,Pauloski BR,Rademaker AW,et al.Oropharyngeal sw allow in younger and older w omen:videofluoroscopic analysis[J].J Speech Lang Hear Res,2002,45(3):434-445.
[8]Feng X,Todd T,Lintzenich CR,et al.Aging-related geniohyoid muscle atrophy is related to aspiration status in healthy older adults[J].J Gerontol A Biol Sci M ed Sci,2013,68(7):853-860.
[9]Bucchieri A,Mastrangelo C,Stella R,et al.Cephalometric evaluation of hyoid bone position in patients w ith obstructive sleep apnea[in Italian][J].M inerva Stomatol,2004,53(1-2):33-39.
[10]Jacobson A.Investigating the correlation between the severity of obstructive sleep apnea and position of the hyoid bone,Nicholas A.Dahar,Saint Louis University,St Louis,M o[J].Am J Orthod Dentofacial Orthop,2007,132(12):269.
[11]Cho HW,Kim IK.Retrospective study of changes in pharyngeal airw ay space and position of hyoid bone after mandibular setback surgery by cephalometric analysis[J].Maxillofac Plast Reconstr Surg,2015,37(1):38.
[12]Lew KK.Changes in tongue and hyoid bone positions follow ing anterior mandibular subapical osteotomy in patients w ith Class III malocclusion[J].Int J Adult Orthodon Orthognath Surg,1993,8(2):123-128.
[13]Pae EK,Quas C,Garrett N.Can facial type be used to predict changes in hyoid bone position w ith age?A perspective based on longitudinal data[J].Am J Orthod Dentofacial Orthop,2008,134(6):792-797.
[14]Jung SK,Kim TW.The relevance analysis of hyoid bone position to skeletal or dental openbite and dentofacial characteristic s[J].Oral Surg Oral M ed Oral Pathol Oral Radiol,2015,120(4):528-533.
[15]Guijarro-Martínez R,Swennen GR.Three-dimensional cone beam computed tomography definition of the anatomical subregions of the upper airw ay:a validation study[J].Int J Oral M axillofac Surg,2013,42(9):1140-1149.
[16]Jiang J,Xu T,Lin J.The relationship between estimated and registered natural head position[J].Angle Orthod,2007,77(6):1019-1024.
[17]Kim YH.A comparative cephalometric study of Class II,Division 1 nonextraction and extraction cases[J].Angle Orthod,1979,49(2):77-84.
[18]Alves MJ,Baratieri C,Mattos CT,et al.Is the airway volume being correctly analyzed?[J].Am J Orthod Dentofacial Orthop,2012,141(5):657-661.
[19]Chauhan A,Autar R,Pradhan KL,et al.Comparison of pharyngeal airw ay dimension,tongue and hyoid bone position based on ANB angle[J].Natl J M axillofac Surg,2015,6(1):42-51.
[20]Deljo E,Filipovic M,Babacic R,et al.Correlation analysis of the hyoid bone position in relation to the cranial base,mandible and cervical part of vertebra w ith particular reference to bimaxillary relations/teleroentgenogram analysis[J].Acta Inform M ed,2012,20(1):25-31.
[21]Malkoc S,Usumez S,Iseri H.Long-term effects of symphyseal distraction and rapid maxillary expansion on pharyngeal airw ay dimensions,tongue,and hyoid position[J].Am J Orthod Dentofacial Orthop,2007,132(6):769-775.
[22]Malkoc S,Usumez S,Nur M,et al.Reproducibility of airw ay dimensions and tongue and hyoid positions on lateral cephalograms[J].Am J Orthod Dentofacial Orthop,2005,128(4):513-516.
[23]Bickerton D,Szathmry E.Biological foundations and origin of syntax[M].Cambridge:M IT Press,2009:327-329
[24]Tarkar JS,Parashar S,Gupta G,et al.An evaluation of upper and low er pharyngeal airw ay w idth,tongue posture and hyoid bone position in subjects w ith different grow th patterns[J].J Clin Diagn Res,2016,10(1):79-83.
[25]Jena AK,Duggal R.Hyoid bone position in subjects w ith different vertical jaw dysplasias[J].Angle Orthod,2011,81(1):81-85.
[26]Paul D,Varma S,Ajith VV.Airway in Class I and Class II skeletal pattern:a computed tomography study[J].Contemp Clin Dent,2015,6(3):293-298.
[27]Gobeille DM,Bowman DC.Hyoid and muscle changes follow ing distal repositioning of the tongue[J].Am J Orthod,1976,70(3):282-289.
[28]Staudt CB,Gnoinski WM,Peltomaki T.Upper airway changes in Pierre Robin sequence from childhood to adulthood[J].Orthod Craniofac Res,2013,16(4):202-213.